key: cord-0709369-y4639p9m
authors: Rottenberg, Yakir; Goldzweig, Gil; Baider, Lea
title: Geriatric patient-centered care during the COVID-19: Provision of interactions vs. the imposition of isolation
date: 2020-06-18
journal: J Geriatr Oncol
DOI: 10.1016/j.jgo.2020.06.016
sha: 2b09156da3b5a4848464d6ec6cf765bb8940c3ca
doc_id: 709369
cord_uid: y4639p9m

nan

Age is one of the dominant risk factors for morbidity and mortality from the emerging COVID-19. 1 Older persons diagnosed with cancer, their families, and the medical staff face a meticulous trade-off between aggressive physical/social distancing and maintaining as close an interaction with family and community life as possible. This conflict, between the need for close contact that gives a sense of meaning and imposed isolation, while relevant for healthy older person, is aggravated following infection and has a tremendous impact at the time of near death.

Patients as well as family members and health care teams have to confront dilemmas and make difficult decisions such as whether to interrupt ongoing treatment due to possible infection or whether to allow family members to accompany older patients who cannot travel alone to treatment and feel too fragile and vulnerable to be alone. The regulations dictated by the pandemic crisis although for the benefit of the patients may be perceived as external imposition without being integrated part as active participation. This seems to contradict older patients' preference for autonomy and decision-making about their life and health. 2

It can be hypothesized that the COVID-19 virus and the chronic condition of cancer goals of the older patients population increases with age. 10 As they get older, people turn their attention inward and tend to invest in close and meaningful relationships.

In most families, the current isolation policy and total uncertainty alongside the fears of older patients with cancer becoming infected contradict the basic physical needs of security, namely, the need to touch, embrace, hear the sound of a familiar voice, and not be abandoned. 

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